05D2295758 CLIA NUMBER - INNER-TRIBAL TREATMENT

Laboratory Demographics

  • CLIA Code: 05D2295758
  • Facility Name: INNER-TRIBAL TREATMENT
  • Facility Address: 16160 CA-76 SUITE 401
    PAUMA VALLEY, CA
    ZIP 92061
  • Facility Phone: 760 638-3665
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN SMALL
  • NPI Number: 1609555887
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2295758
LAB Type Comp. Outpatient Rehab Facility
Facility Name INNER-TRIBAL TREATMENT
Street 16160 CA-76 SUITE 401
City PAUMA VALLEY
State CA
ZIP 92061
Phone 760 638-3665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director CHRISTIAN SMALL

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This page was last updated on: 9/29/2025